Older people should never think that mistreatment is part of being old or dependent. Being mistreated threatens their personal dignity and sense of well-being and can even cost people their life.

Detecting mistreatment of older people can be difficult. Older people may be reluctant to tell others about it, or they may be unable to tell others because the perpetrator limits phone calls or access to visitors and health care practitioners.

If older people believe they are in danger, they can call an elder abuse hotline for immediate help. Such hotlines are listed in the local phone book, usually in the Blue Pages, or can be provided by a phone operator. A list of all state laws about elder mistreatment and telephone numbers to call to report mistreatment are available at the web site of the National Center for Elder Abuse. The local Area Agency on Aging is another good source of information and referral. If older people do not feel endangered but still want help, they can try talking about it with their doctor or other health care practitioner. However, many health care practitioners are unfamiliar with how to handle elder mistreatment because the topic has not traditionally been part of medical training and education.

Because mistreatment and its effects can vary greatly, interventions need to be tailored to each person's situation. Interventions may include the following:

• Medical assistance
• Education, such as information about mistreatment and available options, as well as help with devising safety plans
• Psychologic support, such as psychotherapy and support groups
• Law enforcement and legal intervention, such as arrest of the perpetrator, orders of protection, and legal advocacy
• Arrangement for alternative housing, such as housing that provides safe shelter with protection from the perpetrator

Relatives, friends, and acquaintances have a responsibility to help if they know of or strongly suspect mistreatment, as do health care practitioners. Directly confronting the perpetrator is not recommended because it can worsen mistreatment. Instead, the situation should be reported. Reporting suspected or confirmed abuse or neglect is mandatory in all states if the mistreatment occurs in an institution and in most states if it occurs in a home. Every state has laws that protect and provide services for vulnerable, incapacitated, or disabled people. Every state also has laws protecting people who report suspected mistreatment from being sued for doing so. To report mistreatment, people can contact the following:

• In most states: The state social service department (Adult Protective Services)
• In a few states: The state unit on aging
• For abuse within an institution: The local long-term care ombudsman's office or the state department of health

Telephone numbers for these agencies and offices in any part of the United States can be found by calling the Eldercare Locator (800-677-1116) or the National Center on Elder Abuse (202-682-2470) and giving the person's county and city of residence or zip code.

Last full review/revision February 2009 by Mark S. Lachs, MD, MPH